For your convenience we have provided an interactive PDF of the Patient Information Form for you to fill out and submit online or you may choose to download the form for manual submission by fax, mail or delivery to the office. If you have any questions, please call us directly at (541) 484-1943. Click on the form links below to access that online form.

ONLINE FORMS AVAILABLE:
New Patient Information Form (PDF)

NOTE: The above files are in PDF format — Adobe Reader is required. Click on the link below to download a free version of Adobe Reader.